01/05/09 — Hospital to balance economy, 2009 plans

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Hospital to balance economy, 2009 plans

By Phyllis Moore
Published in News on January 5, 2009 1:46 PM

Wayne Memorial Hospital is not immune to the financial troubles that have the world on edge, but hospital President and CEO Bill Paugh says that despite the economic uncertainty, the hospital remains committed to improving facilities and care.

The hospital is in the process of making improvements in several areas, he said, including technology, new programs and infrastructure.

But hospital officials are keeping a close eye on money.

"We have made that commitment, and we'll carry through that commitment, but at the same time, you're watching things that typically are pretty stable, becoming very unstable in the marketplace," Paugh said.

Part of the financial crisis the hospital dealt with was its debt on previous projects, such as the energy plant. Officials were required to look at alternatives in terms of restructuring that debt while maintaining required cash on hand.

"The financial people would tell you, you don't want to have cash on hand that's not generating revenue," Paugh said. "This hospital has had a good portion of those dollars invested in equities, in the stock market."

It's a struggle, he admits.

"We're sitting here trying to do what we need to do to provide care in this community, and have an operating margin," he said. "We'd like for it to be 4 to 41/2 cents on a dollar, which it has been. Now it's more like one cent on the dollar. What do we have left over after paying all of our operating expenses over the year? It's actually a little over a penny (for every dollar)."

One of the main projects begun during the past year has been converting the hospital to Medi Tech, a computerized clinical and financial information system that affects virtually all departments.

Although there are already 2,000 hospitals across the country using the system, the latest version is relatively new and Wayne Memorial will only be the third hospital in the nation to introduce it.

Modifications are also being made to the hospital's nursing model -- from a team concept to a primary nursing model -- which entails moving the level of care closer to the patient rather than to the nursing station.

"What's this going to look like at the bedside? It's basically a computer on wheels, but it's much beyond that. It's a specially designed cart that allows the nurses to have the things available to her," Paugh said.

It's an expensive system and an expensive commitment from the hospital's standpoint, Paugh said.

"It's really taking a look at how we want care provided at the bedside. We really wanted to make sure that they have the information available to help him or her," he said.

Wayne Memorial regularly measures itself against similar-sized hospitals, Paugh said, to ensure patients are getting the best care possible.

"We feel like we can document and we have got the statistics to be able to show that this institution is an institution that provides quality care. As you ride by this place every day, you wouldn't see the changes, but a lot of time and attention to make sure the infrastructure is there and supports what we're trying to do."

The hospital stacks up well comparatively, its president says.

"We feel fortunate, we have worked very closely with Wayne Community College in terms of trying to provide scholarships for folks that are from here, if you will, to go to the community college and get nursing degrees. We have been successful in terms of reducing the number of slots that we deal with in terms of contract labor."

Public perception is important, he said.

"More than 93 percent of our in-patients that we see here agree with the statement that 'overall I'm pleased with the quality of care provided at Wayne Memorial Hospital,'" Paugh said. "That's a huge measure for us aside from the things from the inside that one would define quality medical care as."

The emergency department is also monitored, with level of satisfaction running about 83 percent, Paugh said. That is impressive, he noted, considering that department registers about 50,000 visits a year.

"I think having people who have recently been treated here seeing it as positively as they do, I just wish I could figure out how to make those who have concerns view it this way," Paugh said. "I'm not going to compare myself to a swan, maybe a duck -- what you can't see below the water line."

Looking to the year ahead, Paugh said the economy will remain a big issue for many reasons -- funding construction and other projects as well as the job market and insurance among them.

But the major challenge, he said, will be to continue to enhance services the hospital provides despite the economic uncertainty.

"When you need health care, you need it now," he said.

Fortunately, Paugh said he feels confident in the product Wayne Memorial offers.

"This community is very blessed to have the level of sophistication and complexity that it does. You don't expect to find that in a community this size. We have got to continue to work to make sure that for those in the next generation of folks, that we continue to make sure that we, as we have done in the past, have the ability to recruit and retain folks who can provide that level of expertise."

Another area in which the hospital plans to continue to work is recruiting physicians.

"There are a lot of moving parts for that equation as well -- primary care and the fact that not as many people are choosing that as a career path for the future, and what can you do to make this medical community a community that someone would want to come and practice in and stay and spend their career?" he said. "It really affects the other specialties as well, in terms of what physicians coming out of residencies are looking for."